Monday is destined to be a depressed day for Xiao Li in the Department of Anesthesiology. It was supposed to be a lighthearted day, but the director asked her to temporarily take over the operation of a sick colleague.
She felt a lot of pressure when she received the surgery. This patient does not seem to be the one who saves his heart: he has a shaggy beard and a red face, and at first glance, he looks like an alcoholic. When asked about his medical history, he was indeed addicted to alcohol. It is said that I get a pound every day. Not only that, but I also have the habit of taking painkillers. Plus age, each greatly increases the difficulty of anesthesia.
At this time, some friends may ask: The numbness is over, and no matter how much alcohol you drink, it can be numb!
As the saying goes, there is no one who can’t get over it. However, how to ensure a smooth and safe recovery during the operation is the core of anesthesia.
To make matters worse, an inhalation anesthetic with a low rate of agitation during recovery just happened to be gone that day. And she, who is accustomed to static inhalation of compound general anesthesia, can only bite the bullet.
At this time, there will be an insider who will say: Wouldn’t it be over if the intravenous general anesthesia is directly applied? Numerous data show that recovery from intravenous general anesthesia is significantly less agitation than inhaled general anesthesia.
She is well aware of this. However, there is a consensus in the anesthesia industry: choose the anesthesia that you are better at, not the theoretically better anesthesia.
Considering that male urinary catheter is the main cause of restlessness during recovery, she specially instructed the nurse who inserted the catheter to apply some anesthetic glue. But it turns out that the effect is not great. Might have an effect, but not so much in this patient.
Awakening period, the real test is coming. Seeing the BIS value rising little by little, she became more and more excited. In theory, agitation can generally be controlled as long as the patient is sufficiently awake.
However, in her eagerness to succeed, she overlooked one point: the seemingly quick recovery data masked the slow release of the anesthetic gas from the deep tissue. Moreover, this process generally takes nearly half an hour.
In other words, deep tissue recovery from anesthesia is true awakening, but not at this time.
Saw the patient swallowing the endotracheal tube, and a wake-up needle went in. The stimulation of the tracheal tube and urinary catheter instantly made the patient disobey the command and struggled violently to get up. That kind of power, several girls can’t hold back.
Aware that the patient had agitation during recovery, Xiao Li resolutely injected short-acting intravenous general anesthesia. In this way, the patient was anesthetized again.
This time, the patient slept for over twenty minutes.
Woke up again, seemingly more sober than before, but still almost drunk.
That’s it, the only thing you can do is to take another dose and continue to sleep.
After more than ten minutes, the patient was finally fully awake. However, the irritation of the catheter still made it difficult for him to calm down.
At this time, Xiao Li recalled: This man has an enlarged prostate. Such patients have stronger urethral irritation.
After thinking about it, I decided to inject a long-acting pain reliever to relieve the irritation of the catheter.
After the patient is calm again, the patient is taken out of the operating room.
Xiao Li at this time has mixed feelings in his heart: in this job, success is a matter of his own; if he fails, others may think that you are not good enough. As everyone knows, one patient after another has the exact same physique and the same surgery. These are all factors that affect the quality of anesthesia.